Objective To explore the value of inflammatory markers in predicting paroxysmal sympathetic hyperactivity (PSH) after traumatic brain injury (TBI). Methods A total of 84 TBI patients who were admitted to The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Dec. 2016 to Nov. 2020 were retrospectively analyzed. They were classified into PSH group (n＝41) and non-PSH group (n＝43) according to whether PSH occurred during hospitalization. The baseline data and laboratory results of the 2 groups were collected and compared. Kendall correlation analysis was used to analyze the correlation between inflammatory markers and the occurrence of PSH after TBI, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of inflammatory markers to PSH. Results There were no significant differences in baseline data, including age, gender, or Glasgow coma scale score, between the 2 groups (all P＞0.05). Compared with patients in the non-PSH group, the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophils and leukocytes in the PSH group were significantly increased (all P＜0.05). NLR, SII and neutrophil were positively correlated with PSH (r＝0.360, 0.308, 0.289; all P＜0.01), with the corresponding ROC area under curve values being 0.752, 0.716 and 0.702, respectively. Conclusion NLR, SII and neutrophils have a value in predicting the occurrence of PSH after TBI.